Provider Demographics
NPI:1932084027
Name:CORALVITA HOLDCO LLC
Entity type:Organization
Organization Name:CORALVITA HOLDCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SABETI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-567-4932
Mailing Address - Street 1:400 LAS COLINAS BLVD E
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5579
Mailing Address - Country:US
Mailing Address - Phone:972-567-4932
Mailing Address - Fax:
Practice Address - Street 1:401 W CAMPBELL RD STE 300
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3416
Practice Address - Country:US
Practice Address - Phone:469-329-7300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital